There is a shortage of psychiatrists in the United States, and it’s worse in Florida.

Part of the state’s problem is too few residency slots, said Rajiv Tandon, vice chairman of psychiatry at the University of Florida’s College of Medicine in Gainesville.

There’s about 135 residency positions across the state, with about 25 percent of those graduating in any given year, Tandon said.

Mounting debt necessary to become a doctor combined with psychiatrists earning less than other specialty degrees contributes to the shortage. Another issue is the stigma associated with the mentally ill. Doctors can make more money and have less personal interaction with patients if they specialize in something else.

At issue is there are just not enough psychiatrists to go around and that’s a major problem. In the last three years, the Jacksonville Sheriff’s Office was called to 32,988 cases involving a mentally ill person, according to information supplied by the jail. The majority of the time, police are forced to involuntarily hospitalize people under the state’s Baker Act.

The medical community will soon have more locally produced psychiatrists from a residency program that began in July.

Jacksonville’s first hospital-based psychiatric residency program at UF Health Jacksonville plans to produce three graduates a year.

Residency programs are advanced training for doctors after they graduate from medical school. Newly minted residency graduates are usually in their 30s and are settled in an area, said Steven Cuffe, chairman of the psychiatry department at UF’s College of Medicine in Jacksonville.

The residents have completed about 75 percent of their first year. Three new first-year residents will join the program July 1.

Jason Altmire, senior vice president of public policy and community engagement at Florida Blue, cited a Washington Post investigation that found 89 million Americans live in places where they don’t have access to a mental-health professional.

Another access issue involves insurance coverage.

Altmire, also a three-term former U.S. congressman, co-sponsored the 2008 Mental Health and Addiction Parity Act that requires insurance policies to treat mental illness the same as physical maladies. The problem was it only applied if insurance plans provided coverage for mental-health services, he said.

Many plans opted out of including those services.

The Affordable Care Act, commonly referred to as Obamacare, fixed that. It made mental-health services one of 10 “essential health benefits” that must be covered.

One issue with the “essential health benefits” is large group plans and plans that were grandfathered aren’t required to provide mental health coverage, Altmire said.

He said there’s another concern with the acts. In 2010, about 50 percent of psychiatrists didn’t accept insurance, according to the Journal of American Medicine Association.

The Affordable Care Act also brings millions of people into the health-care system but doesn’t provide for more doctors to treat those patients, Altmire said.

Altmire spoke about the topic and insurance-related mental health issues recently at the Jacksonville Community Council Inc.’s inquiry into mental health. The organization has held weekly meetings about how mental illness is treated in Northeast Florida since the beginning of February.

Prior to last summer, Jacksonville was one of the largest cities without a residency program, Cuffe said. “If you are a big city and you don’t have a residency program, then generally the number of psychiatrists isn’t enough to take care of the needs of the population,” he said.

There are only four hospital-based psychiatric residency programs in Florida — including Jacksonville’s. The others are Miami, Gainesville and Tampa.

About 90 percent of psychiatric residents who graduated from UF’s program stay in the state, Tandon said.

Tracking the exact number of practicing psychiatrists is difficult.

Tandon said at best there’s about 1,800 practicing psychiatrists for a population of about 19.3 million. He said the number is probably closer to 1,500. The Florida Department of Health wasn’t able to provide a breakdown of psychiatrists in the Jacksonville area or statewide.

“This is all ball park,” Tandon said.

About 40,000 to 45,000 psychiatrists practice in the United States, he said. Florida’s rate of psychiatrists per 100,000 residents is about 75 percent of the national average.

Cuffe said after doctors complete medical school, they are often anywhere from $100,000 to $200,000 or more in debt, and psychiatry is among the lowest-paying medical specialties.

That could be a factor, Cuffe said. He also said the stigma associated with mental illness has spilled over into the medical community as fewer doctors pursue psychiatric resident programs.

Ben Burris graduated from Texas A&M’s College of Medicine before joining two other doctors as the first psychiatric residents in Jacksonville. Arthur Higgins, a graduate of St. George’s University School of Medicine, and Neelam Sampley, a graduate of the Medical University of Lublin, are the other two residents.

Burris said he didn’t know what he wanted to specialize in when he started medical school. “But it became clear that I was interested in specialties with the brain,” he said. “The complexity and the mystery of some aspects of the brain drew me in.”

Cuffe said wanting to spend time with the patient is an important trait in a psychiatrist. “I must say you must have to really enjoy talking and getting to know patients,” he said.

Burris has that needed trait.

“You are exploring the world of emotions and behavior, which I find fascinating,” he said.

The residency program is at UF Health Jacksonville but residents will also train at Baptist Health, Wolfson Children’s Hospital, Gateway Community Services and Renaissance Behavior Health.